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TRI STATE EYE OPHTHALMOLOGY OF MIDDLETOWN PC
NPI 1053430256
Specialist in Middletown, NY

Active since March 28, 2007
75 CRYSTAL RUN RD, SUITE 120, MIDDLETOWN, NY 10941(845) 703-2020(845) 703-2901 Get Directions Write a Review

NPPES record last updated: January 30, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tri State Eye Ophthalmology Of Middletown Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRI STATE EYE OPHTHALMOLOGY OF MIDDLETOWN PC (NPI 1053430256) is a healthcare organization registered as a specialist in Middletown, New York and active in the NPI registry since March 2007. The organization lists Severin Bohdan Palydowycz, Owner, as its authorized official.

NPPES Registry Identity

NPI1053430256
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameTRI STATE EYE OPHTHALMOLOGY OF MIDDLETOWN PC
Location Address75 CRYSTAL RUN RD, SUITE 120Middletown, NY 10941-7000
Mailing Address75 Crystal Run Rd, Suite 120Middletown, NY 10941-7000 · (845) 703-2020 · Fax (845) 703-2901
Phone(845) 703-2020
Fax(845) 703-2901
Organization SubpartNo
Authorized OfficialSeverin Bohdan PalydowyczOwner · (570) 296-9696
Enumeration DateMarch 28, 2007
Last NPPES UpdateJanuary 30, 2015
✔ NPI 1053430256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · MD049303L
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
75 CRYSTAL RUN RD, Middletown, NY 10941
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Other Names 1

Doing Business AsTri State Eye Ophthalmology Of Middletown Pc

Other Identifiers 3

Medicare UPINU81549
Medicare UPINF52262
Medicare UPINI04325

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tri State Eye Ophthalmology Of Middletown Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Tri State Eye Ophthalmology Of Middletown PC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (5)

Alexandra Herrera, OD
Optometry
NPI 1427579093
183 MAIN ST
Beacon, NY 12508
(845) 838-2020
✔ PECOS✔ Accepts Medicare21 mi
Severin Palydowicz, MD
Ophthalmology
NPI 1215939483
396 ROUTE 6 AND 209 STE 1
Milford, PA 18337
(570) 296-9696
✔ PECOS✔ Accepts Medicare22 mi
Joseph Haggerty, OD
Optometry
NPI 1629070875
510 ROUTE 6 AND 209 STE 6
Milford, PA 18337
(570) 296-9696
✔ PECOS✔ Accepts Medicare28 mi
Paul Guerriero, M.D.
Ophthalmology
NPI 1982697033
99 DUTCH HILL RD
Orangeburg, NY 10962
(845) 359-7272
✔ PECOS✔ Accepts Medicare35 mi
Lawrence Ross, MD
Ophthalmology
NPI 1013956796
225 FROEHLICH FARM BLVD
Woodbury, NY 11797
(516) 364-5400
✔ PECOS✔ Accepts Medicare64 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tri State Eye Ophthalmology Of Middletown PC's NPI number?

The NPI number for Tri State Eye Ophthalmology Of Middletown PC is 1053430256. It was assigned to this organization in the NPPES registry on March 28, 2007.

Where is Tri State Eye Ophthalmology Of Middletown PC located?

Tri State Eye Ophthalmology Of Middletown PC is located at 75 Crystal Run Rd Suite 120, Middletown, NY 10941. The listed phone number is (845) 703-2020.

What is Tri State Eye Ophthalmology Of Middletown PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Tri State Eye Ophthalmology Of Middletown PC enrolled in Medicare?

Yes. Tri State Eye Ophthalmology Of Middletown PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tri State Eye Ophthalmology Of Middletown PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Tri State Eye Ophthalmology Of Middletown PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Ophthalmology (3) and Optometry (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Tri State Eye Ophthalmology Of Middletown PC was last updated on January 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.